Long thread, but interesting article

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TweetThe Nassau Lawyer
January 2002
SPORTS, STERIODS AND THE MEDIA
BY RICHARD D. COLLINS


Preventing athletes from "cheating" with performance-enhancing pharmaceuticals and protecting teenagers from drug abuse are laudable societal goals. In their furtherance, the sports community, government agencies and a few physicians have for several decades waged a propaganda campaign against anabolic steroids. Regrettably, many of these well-intentioned statements have been exaggerated, misleading or simply false, resulting in a "demonized" view of anabolic steroids1 in the public perception and in the attitudes of key figures in the criminal justice system. Based upon what they have heard or read, many prosecutors and judges see no reason to distinguish between the relative dangers of "hard drugs" like cocaine and heroin and the inherent risks of steroids. Indeed, media reports of the death of sports figures like Lyle Alzado and tales of violent steroid-induced rages have provoked some jurists to perceive anabolic steroids as an even greater social menace than narcotics.

The view of steroids as "deadly drugs" can adversely affect plea and sentence negotiations, especially in trafficking cases. It is essential for defense counsel to be prepared in advance to rebut this mindset and offer a well-researched alternative view. This article introduces some of the necessary basic references.

What are Anabolic Steroids?
Unlike all the other drugs listed in the Controlled Substances Act, anabolic steroids are hormones. Anabolic steroids are synthetic derivatives of testosterone, the primary male sex hormone or "androgen." They are synthesized from cholesterol and are part of the same large family of substances encompassing birth control pills and such anti-inflammatory drugs as prednisone and cortisone.

Testosterone, which naturally occurs in both men and women, has both anabolic (muscle building) and androgenic (masculinizing) properties. Recognizing the potential for improving muscularity and athletic performance, California strength athletes probably began self-administering testosterone in the 1940?s. By the early 1950?s, scientists were trying to create more safe and effective substances by maximizing the anabolic properties of testosterone while minimizing the androgenic effects. Many different variations were developed, and by the mid 1960's had found their way into the hands of competitive athletes as well as non-competitive "cosmetic" users seeking improved appearance.

Most people who self-administer steroids today are non-competitive weight trainers seeking purely cosmetic physique enhancement. Steroids are typically used in calculated "cycles" as part of an overall strategy including a high-protein diet, supplementation with vitamins and herbs, and high-intensity weight training to achieve levels of physical enhancement that might not be possible without them. Users typically self-administer various ancillary medications to prevent or reduce any side effects that appear. Because the possession of steroids for bodybuilding is a crime (see infra), few users are willing to seek medical monitoring or advice.

History of the Criminalization of Anabolic Steroids
In the mid 1980's, complaints from the organized sports community about the use of drugs, particularly anabolic steroids, to gain an unfair advantage in competitions, began appearing in the media with increasing frequency. Steroid use in sports catapulted to the forefront of public consciousness at the Seoul Olympics in 1988 when Canadian sprinter Ben Johnson was stripped of his 100-meter gold medal for testing positive for the steroid stanozolol. Overnight the Olympics became tarnished, with public suspicions of epidemic steroid use spilling over into other organized sports. Press reports began citing teen usage and printing "Reefer Madness-like" claims of steroid dangers.2 Congress was galvanized into action with the goal of helping organized sports to rid steroids from athletics.

Between 1988 and 1990, Congressional hearings were held to determine whether the Controlled Substances Act should be amended to include anabolic steroids.3 Significantly, representatives of government regulatory agencies including the FDA, the DEA and the National Institute on Drug Abuse testified against the proposed amendment to the law. Even the American Medical Association vigorously opposed it, maintaining that steroid abuse does not lead to the physical or psychological dependence required for scheduling. But Congress seemed less concerned about any psychologically addictive properties of steroids or public health dangers. The majority of witnesses at the hearings were representatives from competitive athletics whose testimony focused on the purported need for legislative action to solve the "cheating" problem.4

Congress passed the Anabolic Steroid Control Act of 1990,5 appeasing the organized sports lobby. The law added anabolic steroids to the federal schedule of controlled substances, criminalizing their non-medical use by those seeking muscle growth for athletic or cosmetic enhancement. It places steroids in the same legal class (Schedule III) as amphetamines, methamphetamines, opium and morphine.6

The law and similar state statutes reach far beyond the Olympic and elite level athletes for which they were originally intended. They criminalize "cosmetic" (muscle-building) steroid use for all mature adults, and prevent physicians from prescribing steroids to healthy adults for such purposes.

The Media and Anabolic Steroid Effects
Like all prescription medications, anabolic steroids can have adverse side effects, including serious ones, particularly if self-administered in the absence of medical supervision or in excessive dosages. Societal concerns about the hazards of adolescent steroid usage are valid, as they are about teen alcohol use. Generally less focused upon long-range health than adults, more susceptible to peer pressure, and eager for fast results, teenagers are more likely to use steroids irresponsibly. Since the effects of steroids upon size and strength are partially (and sometimes even completely) temporary, teens seem particularly less willing to suffer post-cycle size and strength reductions, and are more likely to continuously use high-dose steroids for prolonged periods. While anabolic steroids may be safely administered to women in small dosages for medical reasons, these steroids are, after all, male hormones. Particularly at prolonged high dosages, the potential adverse effects of steroids upon female users may include excessive growth of body hair, male pattern balding, deepening of the voice, breast tissue reduction, alterations in menstrual cycles, and clitoral enlargement.

But the case against steroids for mature adult males is far less convincing than is commonly thought. The mainstream media, always seeking the sensationalism of a "big story," has published the most hyperbolic utterances of a few self-professed experts as if they were Gospel truth. Consequently, the average American likely believes that steroids are highly dangerous medications, responsible for countless deaths including the demise of Los Angeles Raider Lyle Alzado. In a 1991 Sports Illustrated interview,7 Alzado blamed steroids for his brain cancer. Actually, the T-cell lymphoma that killed Alzado has never once been associated in the medical literature with steroids despite use by three million athletes over five decades. Although unsupported by any evidence, the rough-and-tumble Alzado?s speculations are widely accepted as true even today.8

Media reports have linked anabolic steroids with frightening dangers to the liver, heart, prostate and connective tissues. These reports often fail to stand up to scrutiny. In some cases, the medical research underlying these reports has been of questionable applicability to healthy athletes (many studies have focused on patients who were already very sick and old). Other studies have failed to differentiate between types of anabolic steroids, improperly generalizing adverse effects to all anabolic steroids (particularly in the association of steroids to liver problems).9 In many cases, the lay press has simply exaggerated the risks for sensationalistic effect.

Even steroid-induced aggression ? so-called "roid rage" ? is a far less common occurrence than the public is led to believe.10 It is even conceded by anti-steroid authorities that "[i]f this phenomenon is real, it is relatively rare (probably less than 1 percent) among steroid users. Even among those affected, the impact of previous mental illness or abuse of other drugs is still unclear."11 "Some long-time steroid users have never suffered any emotional instability, or anything more than transient physical effects" and many steroid users describe non-violent feelings of euphoria, well-being and enhanced self-confidence as common effects.12 Indeed, the relationship between anabolic steroids and aggressive behavior is far more complex than the press has reported, and the most exhaustive review of the medical literature did not find consistent evidence for a direct causal relationship between steroid use and aggression even in those affected.13

It may be surprising that contrary to media reports, many authorities that have objectively reviewed the overall medical literature have concluded that "[a]s used by most athletes, the side effects of anabolic steroid use appear to be minimal."14 Certainly, anabolic steroids have not been shown to have anywhere near the risks of death or disability to healthy adults associated with cigarette smoking, cocaine use, or chronic alcohol abuse. A comparative risk analysis of cosmetic anabolic steroid administration to cosmetic surgery procedures presents an interesting irony. Many more people have died or been permanently injured from botched liposuctions and other cosmetic surgery procedures in the past few years than in over fifty years of non-medical anabolic steroid use.15 Yet it is criminal for a physician to administer anabolic steroids to a healthy adult for purposes of cosmetic physical enhancement but perfectly acceptable (and quite lucrative) to perform the much more radical and dangerous procedure of surgically implanting foreign prosthetics into virtually all parts of the human anatomy for the same purpose.

Studies refuting the common view of steroids receive mysteriously little attention. For example, a landmark 1996 study found virtually no adverse effects when anabolic steroids were administered at a supraphysiologic dosage of 600 mgs per week (about six times natural replacement dose) for ten weeks.16 Significantly, the dose and duration approximate a typical moderate cycle for many steroid-using bodybuilders. Further, studies showing the significant benefits of anabolic steroid administration often go unnoticed by the general public. For example, anabolic steroid therapy can greatly improve the quality of life in HIV positive men by increasing protein utilization for muscle growth (actually stopping or reversing AIDS-related wasting), increasing appetite, stamina and libido, and promoting a general feeling of well-being.17 Anabolic steroids are also becoming a key weapon in the anti-aging arsenal of our graying society. The judicious use of anabolic steroids can significantly improve physical conditioning and sexual performance in mature men, and may help lower serum cholesterol.18

Conclusion
Despite a virtually one-sided presentation in the media, the position that anabolic steroids are "deadly drugs" is surprisingly controversial. The truth about anabolic steroid health risks is inconsistent with what the public, including those in the justice system (and members of Congress), have been led to believe. While a reevaluation of the criminalization of steroids for mature adults may be warranted, 19 the current laws do proscribe their non-medical use. But whatever punishment is imposed should be based upon accurate information, not upon the blind acceptance of unsupported propaganda in the press.



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Rick Collins, Esq., is a criminal lawyer and a recognized legal authority on sports drugs. He has defended clients charged with steroid offenses across the country and is a partner at Collins, McDonald & Gann.

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